Change of Details

Business Name

Given Name(s)*

Surname*

Previous Residential Address

Street Address:*

City:*

State:*

Post Code:*

Country:*

Current Residential Address

Street Address:*

City:*

State:*

Post Code:*

Country:*

Postal Address same as Current Residential Address*

YesNo

Email Address

Phone Number*

Details to Change*

Rates AddressDog RegistrationCat Registration

*Please note

Please Note: This form does not allow you to change the address of a dog or cat registration if there is no existing registration within the Shire of Bridgetown-Greenbushes. To register your dog or cat, you will need to complete the appropriate registration form which can be found on our Ranger Services page.

Do you require a response?*

YesNo

Declaration*

I agree that the information provided is true and correct and that I am authorised to request these changes.

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